SPEECH AND LANGUAGE
Speech and language therapy and the Knowles
Edge Standards Fund Project: an evaluation of the
service provided to a cluster of primary schools
Sue Roulstone, Rosalind Owen and Lucy French
In 2000, 25 speech and language therapy projects
were established in schools in England, funded
through the Standards Fund. An evaluation
commissioned by the Government reported positive
results and gave an overview of all the projects at a
point approximately six months after their inception.
Although there were common themes, it was quite
clear that the projects differed widely in their
structure and interpretation of the original brief.
In this article, Sue Roulstone, Professor of Speech
and Language Therapy at the University of the West
of England, and Rosalind Owen and Lucy French,
both specialist speech and language therapists
working for the United Bristol Healthcare NHS
Trust, provide an in-depth report of one of the
projects and its evaluation after 18 months.
The project, based on a systems analysis approach,
targeted its interventions at the individual child,
the parents, the teachers and therapists, the
classrooms and schools, and more strategic levels
in the health and education services. The article
gives details of the ‘interventions’ for each
component. An independent evaluation gathered
qualitative and quantitative data that suggest that
the new service had a positive impact on all aspects
of the system. Children made gains in their speech
and language; parents were informed and involved;
therapists and teachers were more satisfied about
their knowledge base; and systems changed within
the schools to reflect and support the collaboration.
The outcomes of the project led to a rolling out of
the model to two more cluster groups of schools. A
number of organisational structures were identified
which support the ongoing collaboration. Details
given in this article will enable others to identify
whether or not this model might suit their local
circumstances and be replicable in their context.
Key words: speech, language, therapy, primary
schools, evaluation.
In 2000, the Department for Education and Employment
(DfEE, now the Department for Education and Skills, or
DfES) supported a number of pilot projects on speech and
language therapy in education contexts through the
78 British Journal of Special Education • Volume 32 • Number 2 • 2005
Standards Fund. This was funding awarded to a number of
local education authorities (LEAs) in England according to
the strength of their applications and devolved to schools to
enable them to raise levels of pupil achievement. The Green
Paper Excellence for All Children (DfEE, 1997) had
highlighted difficulties faced by education authorities in
securing speech and language therapy services to children
in schools. A working group set up to investigate these
problems had recommended that funding should be made
available through the Standards Fund as a pump-priming
mechanism, to encourage collaborative working and
strategic co-operation between National Health Service
(NHS) Trusts and LEAs (DfEE, 2000). Funding was
eventually provided to 25 projects.
The evaluation of the original projects (Barber, Farrell &
Parkinson, 2002) reported ‘extremely positive’ findings,
including changes in the children’s skills, strategic changes
in provision and changes in the culture among the
professionals involved. The report was completed a year
after funding first became available, although at that point,
due to delays in recruitment, some of the projects had only
been in operation for six months. The evaluation was based
mainly on questionnaires completed by the project staff but
also included three more detailed case studies. It was not
within the remit of the evaluation to compare the outcomes
of the projects or their relative merits. In terms of the
structure of the projects, there were common themes, such
as the development of joint service delivery models,
training packages and resources. However, the overview of
all the projects shows the variation in how the original brief
was interpreted. Some projects funded only speech and
language therapists (SLTs), whereas others funded assistants,
psychologists and teaching assistants. One focused on the
evaluation of videoconferencing; one provided intensive
input to schools on a rota basis; one compared three
different ways of collaboration; only one targeted
secondary schools.
Given the range of projects, the limitations of the Barber
evaluation and the lack of detail available regarding the
interventions, it would be difficult for anyone planning
future speech and language therapy services to identify a
‘right’ way to progress. More detailed descriptions and
evaluations of the individual projects may help to illustrate
and expand the results reported by Barber et al. A number
© NASEN 2005
of the projects built in longer-term evaluations, and this
paper presents the outcomes from the Bristol-based Knowle
Edge project after 18 months operation. This report
provides a summary of the model used, the related
interventions and the project outcomes at 18 months.
Model of intervention
The basic premise of the Bristol Knowle Edge model is that,
in order to have the best possible impact on children’s
speech, language and communication functioning, the focus
of intervention must be broader than that of the child alone.
It takes what could be regarded as a systems analysis
approach (McCartney, MacKay, Cheseldine & McCool,
1998) and was based on an earlier project in the area, which
was funded by local schools (Wren, Roulstone, Parkhouse
& Hall, 2001). The Knowle Edge Standards Fund project
aimed to impact upon five components: the children; the
parents; the teaching and therapy staff; the schools and
classrooms; and, finally, strategic structures in the health
and education services. Objectives and work plans were
developed for each component. This section provides a
summary of the main interventions.
Children
The central aim of the Knowle Edge Standards Fund project
was to improve provision for children with communication
difficulties, to help ensure better access to the curriculum
and to provide greater opportunities for them to realise their
educational and social potential. Although the project took
a systems view of intervention, individual children and their
particular difficulties with speech, language and
communication remained at its heart. The children to be
seen by the SLT were negotiated termly by the SLT and the
special educational needs co-ordinator (SENCo) of each
school. Priority was given to those at the stage of School
Action Plus or above on the Special Educational Needs
Code of Practice framework (DfES, 2001) and to those
whose communication difficulties were adversely affecting
academic progress or personal or social well-being.
Decisions about levels of input we re made jointly by
the SENCo and SLT, after consultation with parents,
class teachers, other professionals involved and, to some
degree, the children themselves. Input for a child at any
particular time tended to fall into one of the following
categories:
• Direct input, where the SLT worked directly with the
child for weekly or fortnightly sessions. These were
held in class, or in a designated nearby room, often
individually, but sometimes in a group. Work with the
therapist was supported by activities carried out by
teaching staff and/or parents.
• Guided intervention, where the SLT provided
individually planned activities and strategies for the
child’s teachers, learning support assistants and/or
parents. Progress was monitored and reviewed.
• Follow-up where the child’s progress was monitored,
after a period of intervention, for consolidation and/or
generalisation of skills, with a long-term review date
agreed.
© NASEN 2005 British Journal of Special Education • Volume 32 • Number 2 • 2005
Parents
Another aim of the project was to involve parents in the
work with their child and to develop clear lines of liaison
and support. The SLT was based in school weekly or
fortnightly, and was approachable on an informal basis.
Parents of each child referred to the project were invited to
meet with the SLT to give a case history, observe and
discuss the assessment and therapy, and negotiate targets
and ways of helping. If parents preferred, the therapist was
able to arrange to see them at home. Parents were invited to
participate in therapy in some of the following ways:
• by joining the SLT in regular sessions with their child,
and following these up at home;
• by taking home specific activities to work through with
their child;
• by implementing general advice on supporting their
child’s communication development;
• by meeting with the SLT and/or teacher to plan and
review targets.
Education and therapy staff
Teachers, therapists and learning support staff were key
people in delivering the interventions in school. The project
aimed for closer liaison between them, and focused on their
knowledge base and collaborative practice. The SLTs
delivered training for teachers via an in-service training
(INSET) day in each school. This was one of the five days
per academic year allocated to schools for the purpose of
continuing professional development for staff. The Knowle
Edge training aimed to raise awareness of the breadth of
skills encompassed by the term ‘communication’; to review
the normal pattern of communication development; to raise
awareness of different types of communication difficulties;
and to identify useful strategies, activities and sources of
further help. More specifically targeted training also
occurred, for example, in Makaton signing. Staff meetings
were used to target particular concerns, such as how to
encourage expressive language and how to support speech
development through literacy work.
The SLTs met their own training needs by attending school
INSET days (with input, for example, about new reading
and spelling schemes and about counselling skills); national
courses (for example, about literacy teaching strategies and
about matching language targets to the curriculum); and
meetings of the regional group with specific interest in
school-age children with communication disorders.
An explicit system of liaison was instigated to facilitate
collaboration and joint learning. A period of 30 to 60 minutes
was set aside for the class teacher (accompanied, where possible,
by a learning support assistant) to meet with the SLT at the
points of initial assessment and review. This non-contact
time was to be planned for by the headteacher, and supply
cover made available where necessary. The teacher and SLT
shared views of the child’s progress and problems and
findings from assessments. They agreed the appropriate
type of intervention, and explored working from common
targets, writing individual education plans (IEPs) jointly and
79
sharing documentation. The SLT observed children in class
and created opportunities for teaching staff to observe therapy.
Schools and classrooms
Of particular concern here was the provision of a classroom
and school environment that supported the needs of
children with speech and language difficulties. Video
recording was used as a medium for teachers and SLTs to
work together to improve the quality of interaction in the
classroom. A sample of class time was video recorded,
focusing on a particular child or children. The teacher and
SLT viewed the recording together to identify positive and
negative aspects of communication and interaction. They then
agreed strategies for intervention and reviewed progress.
The SLT took steps to make language work relevant to the
demands of the curriculum by consulting the class teacher
about developments in the medium-term teaching plans for
the class. The SLT provided written feedback to the class
teacher after every therapy session, summarising the aims,
activities and outcomes of the session.
Health and education structures
The involvement of management at a strategic level was
central to the project model. Project funding provided two
full-time SLTs who covered seven primary schools and two
nursery schools. In order to encourage multi-agency
ownership of the project, the local funding component was
provided by the health authority, the LEA and by the
schools themselves. A project team was established
consisting of the headteachers of the seven primary and two
nursery schools; the lead speech and language therapy
manager; the lead educational psychologist for speech and
language difficulties; and a representative from the LEA.
This team met termly to receive reports from the project
SLTs, to agree goals and to solve problems.
Data collection
The first author Sue Roulstone, from the University of the
West of England, was employed independently to evaluate
the project. Quantitative and qualitative data were collected
from the following sources and analysed by the first author:
• Results from a standard set of tests conducted by the
project therapists were recorded for each child at
baseline and again after six months.
• Detailed activity data were collected routinely by the
NHS Trust. A sample (for 75 children) was examined
regarding the frequency and timing of SLT contacts
with the children, teachers and families.
• A series of semi-structured interviews were carried out
by the first author (parents: n=12; headteachers and
therapists: n=9).
• The project therapists interviewed a sample of 12 children
from Years 2 to 6 (ages six to 11) who had been receiving
speech and language therapy as part of the project. The
interviews were semi-structured and used questions,
photos and objects as triggers for conversations. The
first author reviewed the transcripts and analyses
(Owen, Hayett & Roulstone, 2004).
80 British Journal of Special Education • Volume 32 • Number 2 • 2005
• Therapists and teachers completed questionnaires
about their knowledge and attitudes during the first and
last terms of the project.
• The first author facilitated the first four series of
therapist-teacher discussions regarding the video recordings
of classroom sessions. Records were kept of the
problems identified and actions agreed.
• During the process of the project, therapists provided
copies of more than 200 IEPs and other documentation
(such as referral standards and procedures, caseload
summaries and learning records) emerging during the
project.
Outcomes
The children
During the 18-month evaluation period, 185 children from
Foundation stage upwards (aged four to 11 years) were referred
for assessment. Of these, 177 needed some kind of intervention.
For the other eight children, assessment revealed speech and
language skills within the normal range, or concerns and
difficulties that were addressed by advice without further therapy.
Standard sets of test results were collected on 103 children
at baseline and again after six months. These children were
selected successively from those referred over a 12-month
period in the middle of the project time frame. For the
purpose of analysis, therapists assigned these children (70%
of whom were boys) to one of four groups depending on their
predominant problem: language, expressive language, speech
and pragmatics. Figure 1 gives descriptions of these categories.
Figure 1: Descriptions of the four categories of difficulty
Language: difficulties with comprehension as well as expressive
language.
Expressive language: no major difficulties with comprehension but
difficulties with word finding, sentences construction, expressive
vocabulary.
Speech: predominantly problems with the realisation, articulation or
linguistic organisation of the speech sound system.
Pragmatics: difficulties with the social use and understanding of
language.
Table 1 shows the number of children in each group, their
ages, and their baseline and follow-up scores. Paired t-tests
were used to investigate the average differences between
baseline and follow-up in the four groups, allowing the
improvements made by the children to be evaluated. In the
results, we distinguish between clinical and statistical
significance: although some results show improvements
that are statistically significant, these arise from quite small
improvements in the scores. Where the changes in the
scores are small, then the clinical significance or
importance of such changes is likely to be small even where
they reach statistical significance. For the Clinical
Evaluation of Language Fundamentals (CELF) (Wiig,
Secord & Semel, 2000; Semel, Wiig & Secord, 2000),
standard scores are available. These acknowledge the
child’s changing age and therefore take some account of the
changes one would expect through maturation. The results
for the Renfrew Action Picture Test (RAPT) (Renfrew,
© NASEN 2005
1997) and the phonology error rate are not age-adjusted. In
these instances, we use normative data from the tests and the
literature to interpret improvements in mean scores and the
p values. Confidence intervals are also used to interpret the
results which are summarised in Table 2.
significance. Children made gains in their phonology,
which were statistically significant but clinically small (4%
decrease in the number of errors). However, the mean error
rate at baseline in this group was relatively high and
phonology was rarely a target for children in this group.

Table 1: Descriptive baseline and follow-up results Expressive language group (n=12; mean age: 8 years)
Characteristic/ Language group Expressive Speech group Pragmatics Approximately half of the children improved their scores on
outcome (n=45) language group (n=37) group (n=9) the CELF tests but average improvements did not reach
(n=12)
statistical significance. The RAPT was not used for group
Baseline Follow Baseline Follow Baseline Follow Baseline Follow comparisons, because the valid age range of the test was
-up -up -up -up
lower than was appropriate for many of the children.
Mean age in 76.8 83.1 97.5 104.6 72.0 77.9 104.3 112.4
months (23.97) (6.93) (11.67) (8.72) (16.27) (6.49) (16.97) (9.37)
(SD) Gains made in phonology were clinically very small and
only just reached statistical significance (p=0.0). As in the
CELF*
Linguistic 4.0 4.62 6.7 7 7.7 7.8 6.8 7.6
language group, baseline error rates for phonology suggest
concepts (1.4) (1.8) (3.1) (2.5) (2.5) (2.8) (2.6) (3.1) that this was not a major area of concern.
standard score
(SD)
Speech group (n= 37; mean age: 6 years)
RAPT** The average number of consonants correct improved by
Grammar 13.23 17 See text 16.6 20.9 See text
score (7.1) (5.3) (5.5) (5.7) 11%, which was statistically significant and, for a six-month
(SD) period, could be regarded as a clinically important change.
RAPT** On the RAPT, these children made average improvements
Information 22.7 27.24 See text 28.3 32.6 See text of four points, which was statistically significant (p<0.0005).
score (7.9) (5.5) (5.1) (2.8)
(SD) As indicated above, this could be regarded as above the
level of change one would expect through maturation.
CELF*
Recalling 3.7 4.1 4.3 5.3 7.4 7.6 6.8 9.5
sentences (1.1) (1.3) (2.1) (2.2) (3.5) (3.4) (2.5) (7.8) Pragmatics group (n=9; mean age: 8 years 8 months)
standard
score Children in this group were defined by their difficulties in the
(SD) social use of language. These aspects were not captured by
Phonology
the assessments used. It is not surprising therefore that no
% correct 87.8 91.9 96.3 97.8 67.4 78.4 95.7 96.2 significant improvements were noted in their average scores.
(SD) (13.5) (9.7) (5.7) (4.5) (18.2) (16.3) (7.1) (6.2)
*CELF: Clinical Evaluation of Language Fundamentals Table 2: Paired t-test on baseline and follow-up results
**RAPT: Renfrew Action Picture Test for the groups of children
Outcome Statistic Language Expressive Speech group Pragmatics
Language group (n= 45; mean age at baseline: 6 years 4 months) measure group language (n=37) group
(n=45) group (n=12) (n=9)
Children in this group made clinically small, but
CELF* Number: 45 12 35 9
statistically significant, gains in their language. The CELF Linguistic Mean
‘Linguistic Concepts’ sub-test was used as one measure of concepts improvement 0.62 0.33 -0.3 0.78
standard p value 0.01 0.61 0.95 0.29
children’s verbal comprehension. On average, the children score 95% confidence
interval 0.15 to 1.09 -1.06 to 1.72 -0.87 to 0.81 -0.60 to 2.15
improved by less than one-quarter of a standard deviation
on this test; this is statistically significant (p = 0.01). The RAPT** Number: 29 See text 24 See text
Grammar Mean
confidence intervals suggest that the improvements could score improvement 4.69 4.29
p value <0.0005 <0.0005
be as much as one standard deviation but also as little as 95% confidence
interval 3.11 to 6.27 2.17 to 6.42
one-tenth of a standard deviation. On the RAPT, a measure
of expressive language used with children up to the age of RAPT** Number: 29 See text 24 See text
Information Mean
seven years, the children made statistically significant gains score improvement 3.89 4.35
p value 0.001 <0.0005
(p<0.0005 for ‘grammar’ and p=0.001 for ‘information’). 95% confidence
On average, children gained four points in their score. This interval 1.68 to 6.12 2.45 to 6.26
is not a standard score and therefore is not age-adjusted. CELF* Number: 15 12 13 8
Recalling Mean
However, normative data given in the test manual suggest sentences improvement: 0.4 1.0 0.23 2.63
standard p value 0.21 0.74 0.63 0.36
that this is double the rate of progress one would expect score 95% confidence
through maturation during a similar period. On the CELF interval -0.26 to 1.06 -0.12 to 2.12 -0.79 to 1.25 -3.76 to 9.01
‘Recalling Sentences’ subtest, a measure of expressive Phonology Number: 45 12 36 8
% correct Mean
language used with children aged seven and above, 33% of improvement: 4.07 1.56 11.43 0.48
these children improved. The confidence intervals suggest p value <0.005 0.04 <0.0005 0.69
95% confidence
that children were unlikely to be deteriorating and could interval 2.08 to 6.05 0.11 to 3.01 9.49 to 13.38 -2.22 to 3.17
improve by as much as one standard deviation. However, * CELF: Clinical Evaluation of Language Fundamentals
** RAPT: Renfrew Action Picture Test
the overall mean improvements did not achieve statistical

© NASEN 2005 British Journal of Special Education • Volume 32 • Number 2 • 2005 81

The activity data showed that on average, therapists spent No data were available to judge the amount of engagement
just over six hours making nearly 15 contacts per child. Just of parents in therapy. However, there were some comments
under half of that time (42%) was spent with parents, in the interviews with therapists that suggested that parental
teachers or other education staff; 58% was spent in direct involvement had not been particularly high.
contact with the child. Table 3 shows activity data for each
group, showing that there were significant differences Teachers and therapists
between the groups in the mean number of contacts and the Changes occurred in both the education and therapy staff’s
average time spent per group, with the pragmatics group satisfaction with their knowledge base regarding speech and
receiving much lower proportions of contact time than the language difficulties and the curriculum respectively. Some
other three groups. of the quotes from staff suggest that they attributed their
increasing knowledge to the contact and collaboration. One
Table 3: Activity data for the four categories of difficulty teacher said the project had:
Child’s Language Expression Speech Pragmatics P value
problem (SD) (SD) (SD) (SD) ‘… raised my awareness of the different types of
problems and possible causes.’
Mean 19.5 15 14.1 8.6 0.014
number (10.2) (5.3) (4.6) (7.9)
of contacts
Another teacher said the collaboration had been ‘very good’
and added that it was:
Mean time 8.2 6.3 6.2 2.9 0.033
spent (4.9) (4.5) (2.1) (2.9) ‘… interesting to find out more and this has made me
(in hours)
aware of why certain children may not be carrying out
instructions.’
Parents
The parents we interviewed showed knowledge of their Schools and classroom – organisation and classroom interaction
child’s difficulties and the intervention programmes. They There was evidence of changes occurring in organisational
talked about therapy goals and explained how they were aspects of school life and in terms of the interaction within
helping at home. They could indicate whether their child the classroom. In relation to organisational issues, a range
was being withdrawn for 1:1 work or was working in a of procedural and support mechanisms was put in place,
small group, and describe details of the therapy. As one such as explicit referral procedures and a list of useful
parent said: language resources in schools. Schools varied in how they
organised time for liaison and joint planning between SLTs
‘He has trouble with his “f” and his “s” so he … had and teachers. For example, some schools provided
to follow the lines down and then say what was at the additional non-contact time for teachers so that they could
end of the line.’ meet with therapists; others relied on a more ad hoc system.
Schools varied in the reliability with which they initiated
Parents were generally pleased that their child was liaison with therapists. Therapists found it difficult to time
receiving therapy. One parent said: all their reassessments of children to coincide with the IEP
reviews.
‘I’m glad for him to have this opportunity so that they
don’t get the problems that people like me can get as An important theme emerging from our interviews with
you get older – I just got taken the mick out of all the participants was that therapists were seen as part of the
time. I just don’t want it to happen to my child.’ school team. This achievement was attributed, in part, to the
developing relationships between therapists and teachers.
Parents reported positive outcomes. According to one Comments from the headteachers about what helped to establish
parent: the therapist as part of the team are shown in Figure 2.

‘[His grandparents] phone and they couldn’t
understand him before but they can now.’
Generally the parents preferred the current school-based
service to anything they had received previously. One
parent reported that therapy was:
‘… easier at school – he’s used to his surroundings,
easier to build up a relationship, he’s comfortable
and knows what to expect. And with [his sister]…
she grew out of it, but she wasn’t very confident with
the person she seen... It was a strange face and she
was missing school. He hasn’t had to miss school,
has he?’
Figure 2: What helps to make the SLT part of the school
team? Comments from headteachers
The SLT has her own pigeonhole and gets included in all staff circulars.
The SLT was introduced to all the people in school early on.
The SLT was invited to staff meetings early on to introduce the project.
The SLT pins her timetable up on the notice board in the staffroom.
The SLT works through issues with the SENCo.
Therapy items are included on the staff meeting agenda.
The SLT is invited to and attends staff social events.
The SLT is comfortable in the staffroom and smiles a lot.
No formal evaluation of changes to classroom interaction
was undertaken. However, records of discussions kept by
the first author between teachers and SLTs showed that

82 British Journal of Special Education • Volume 32 • Number 2 • 2005 © NASEN 2005

actions were agreed which impinged on classroom activities and
interactions. Examples of these actions are given in Figure 3.
Figure 3: Examples of planned classroom activities and
interactions
Classroom discussions of good listening, using the video to illustrate.
Activities to demonstrate listening/not listening.
Reducing questioning; providing running commentary to a child’s pla y.
Focusing conversations on concrete topics.
Responding appropriately to a child’s attention level.
Speaking a child’s news by proxy, as an interim step to gaining the
confidence to report his/her own news to the class.
Health and education structures
Funding for a continuation of the service was secured
before the end of the Standards Fund allocation. This was
achieved externally to the schools, LEA and health
authority through the Children’s Fund. The Children’s Fund
is part of the Government’s agenda to support
disadvantaged children. This funding links the project in to
a national programme, administered via the Government’s
Children and Young People’s Unit (CYPU), tackling
disadvantages associated with child poverty and social
exclusion. At LEA level, commitment to funding speech
and language therapy through the Standards Fund was
increased, with the addition of two new primary clusters
planning to follow the same model of service provision.
Following the original model, a management group
consisting of the participating headteachers, project SLTs,
the head of speech and language therapy, and
representatives from the LEA met termly. These meetings
were seen as very useful by all participants in terms of
maintaining ownership and control of the project and in
terms of discussing and solving problems. There was no
parental involvement in the management of the project.
Discussion
There are a number of advantages and disadvantages to the
process of conducting an evaluation of a service in situ.
While such an evaluation may feel valid for those
participating in the project, the lack of external comparison
or control makes it difficult to interpret the meaning of the
outcomes in terms of the effectiveness of a particular model.
So, for example, the changes observed in the children could
be seen in terms of spontaneous catch-up, the result of other
changes ongoing within education but nothing to do with
the speech and language therapy input, or as chance
findings. However, given the range of data collected in this
particular service evaluation, one is left with an overall
sense of the impact of the project, not just upon the children
but also on those people and structures which are part of an
intervention but rarely explicitly targeted.
This project had similarities with others funded as part of
the DfES’s initiative, in particular, the emphasis on
collaboration between speech and language therapy
services and education to plan services at all levels of the
organisation. However, this project had some unique
features. It was, in some ways, much smaller than other
© NASEN 2005 British Journal of Special Education • Volume 32 • Number 2 • 2005
projects, being focused on a single cluster group of schools
as opposed to covering an entire Trust or LEA. The buy-in
by local schools encouraged eng agement with the project.
Because the cluster of schools was already used to working
together to solve problems, the project fitted well into
existing structures. The management of the project by the
headteachers of the schools in the cluster meant that the
project was responsive to local needs. Although the project
was small, it was seen as an example of good practice and,
subsequent to the project, the model has been rolled out to
another two clusters. This process was facilitated by the
ongoing interest of the LEA in the project outcomes.
Collaborative working is a developmental process whereby
relationships of mutual trust and respect evolve over time. It
would be unreasonable simply to take an existing model of
working, to implant it elsewhere and to expect it to function
at the same level from the outset. However, there were key
features which emerged as themes from the Knowles Edge
context that seemed fundamental to its perceived success as
a collaborative project.
• Joint management: Data from the interviews showed
that headteachers and therapy staff saw the joint
management of the project as a crucial feature. Therapists
were accountable to the management group and
headteachers saw this as the mechanism whereby they
were able to maintain control over how therapy resources
(and their funding) were allocated. The project therapists
valued the joint management: they retained professional
accountability to their speech and language therapy
manager but could bring problems about the running of
the project to the management group. There was a feeling
that this group facilitated consensus solutions and parity
of standards of provision across the different schools.
• Increased accessibility: Parents, therapists and school
staff valued the fact that the therapists were based on
school premises. Parents felt that their children were
less likely to have their school day disrupted.
Furthermore, they felt that meeting a therapist in a
familiar context would mean that their child was less
anxious and more likely to perform well. School staff
enjoyed the increased accessibility of the therapists and
welcomed explicit timetabling of children and liaison
time. Therapists felt that the increased contact
facilitated relationships with school staff. They were
also able to access school-based training and were
routinely included in school events and information.
• Negotiation of therapy input: At all levels of the
project, the type and amount of therapy input was
negotiated. For example, in order to provide a
systems-based approach, it was discussed and agreed
in the management group that time was needed for
training and liaison as well as direct contact. The
proportions of time for each component were similarly
negotiated. At a more operational level, the selection of
children and the therapist’s role in each intervention
were negotiated and agreed with the SENCo.
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• Needs-driven approaches to therapy delivery: As
indicated above, the nature of input for each individual
child was discussed between therapist and SENCo with
consultation with the child’s parents, class teacher and
learning support assistant. Rather than having a set
approach, the key was to maintain flexibility within a
pre-agreed range of approaches.
Certain practical aspects of these ways of working (such as
the joint management team, the explicit meeting times for
liaison, explicit timetabling of children and therapists, and
meetings to negotiate caseloads) could be viewed as
structures that are required in order to operationalise
effective collaboration in practice. That is, these are aspects
of educational and health services that can be put in place to
support collaboration rather than leaving the process to the
chance engagement of talented and enthusiastic individuals.
However, it is clear that individuals can make an important
contribution to the success or otherwise of collaboration. For
example, Hartas (2004) reported that although organisational
factors, such as the clarity of roles, responsibilities and
expectations, were regarded as crucial by teachers and
therapists, the contribution of the individual was also seen
as important. Examples of supportive individual characteristics
included motivation to collaborate, willingness to listen,
compatibility of personality and sense of humour.
Subsequent to the original national projects, the DfES made
ongoing funds available through the Standards Fund, albeit
not ring-fenced as in the original case. Law, Luscombe and
Roux (2002) reported that only about one-quarter of the
money had been taken up by speech and language therapy
projects and concluded that there was still a long way to go
regarding the joint strategic planning recommended by the
original DfES/Department of Health working group (DfEE,
2000). The funds used in the Bristol Knowle Edge project
did have a pump-priming effect in that alternative funding
was secured for the following two years. Further, Standards
Fund monies have also been used to extend the project to
other clusters. However, there is as yet no move to establish
these projects as service developments, suggesting that any
strategic planning has been unable to make that transition.
This level of local planning between the health and
education services seems particularly difficult to achieve
References
Barber, M., Farrell, P. & Parkinson, G. (2002) Evaluation
of the Speech and Language Therapy Projects
Supported by the Standards Fund 2000–2001.
London: DfES.
DfEE (Department for Education and Employment)
(1997) Excellence for All Children: meeting special
educational needs. London: DfEE.
DfEE (Department for Education and Employment)
(2000) Provision of Speech and Language Therapy
Services to Children with Special Educational Needs
(England): report of the working group. London: DfEE.
DfES (Department for Education and Skills) (2001) Special
Educational Needs Code of Practice. London: DfES.
84 British Journal of Special Education • Volume 32 • Number 2 • 2005
and is noted as an ongoing barrier to effective collaboration
(Law, Lindsay, Peacey, Gascoigne, Soloff, Radford, Band &
Fitzgerald, 2000).
The evaluation of the Standards Fund projects (Barber et al.,
2002) demonstrates the range of ways in which speech and
language therapy is provided in schools. This seems to
reflect the national picture, where the level and range of
interventions offered differs depending on local
agreements. There is some consensus that a ‘consultation
model’ is favoured (Lindsay, Dockrell, Mackie &
Letchford, 2002) but little consensus about how that model
is operationalised (Law et al., 2000) and, indeed, some
challenge about how appropriate the model is in the
education context (Hartas, 2004). The Bristol model took a
systems approach, placing the child’s needs at the heart of
developments but looking holistically at all aspects of the
system and explicitly targeting interventions at all levels of
activity. Thus the Bristol model goes beyond a consultation
model to provide work directly with children both in class
and in withdrawal and to observe and reflect on classroom
practice with teachers.
As indicated, the Standards Fund report produced no
comparative evaluation of the various approaches and there
is little detail elsewhere in the literature about how speech
and language therapy interventions are organised. There is
a growing literature on the characteristics of effective
collaboration and the recently published Clinical
Guidelines from the Royal College of Speech and Language
Therapists (RCSLT, 2004) point a therapist towards a
consideration of the school communication environment
and curriculum; encourage engagement with the broader
context of education policy; and recommend a school-based
collaborative approach. However, research has yet to tackle
the difficult issue of generating compar ative studies of the
outcomes of varying approaches. A first step towards this is
to produce reports that describe and evaluate different
models and then attempt to define the components that
seem critical to children’s outcomes.
Acknowledgements
The project team are indebted to all the children, families
and teachers who have contributed to this evaluation.
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collaboration: being equal and achieving a common goal?’
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© NASEN 2005
Lindsay, G., Dockrell, J., Mackie, C. & Letchford, B.
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UK Edition. London: The Psych o l ogi c a l
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––––––––––––––––––––––––––––––––––––––––––––––––
Address for correspondence
Dr Sue Roulstone
Professor of Speech & Language Therapy
Speech & Language Therapy Research Unit
Frenchay Hospital
Bristol BS16 1LE
Email: admin@speech-therapy.org.uk
Manuscript submitted: June 2003
Accepted for publication: June 2004
85